Apparatus for dilating a body cavity

ABSTRACT

Apparatus for dilating a body cavity comprising at least two elongate elements positioned in generally side-by-side relationship. The elongate elements are movable laterally with respect to each other between a contracted condition wherein first end sections of the elongate elements are closely adjacent one another for insertion into the body cavity, and an expanded condition wherein the first end sections of the elongate elements are circumferentially spaced apart for dilating the body cavity. The elongate elements are arranged to normally occupy the contracted condition, and a control device is provided for selectively moving the elongate elements from the contracted condition to the expanded condition.

TECHNICAL FIELD

The present invention relates to an apparatus for dilating a bodycavity. In particular, the invention relates to a vaginal speculum foruse in gynaecology.

BACKGROUND OF THE INVENTION

A vaginal speculum is used in gynaecology for various proceduresincluding opening of the vaginal cavity for inspection of the uterinecervix and to carry out procedures such as a vaginal examination toobtain swabs and scrapings for a papanicolaou stain test, and to do acolposcopy.

A type of vaginal speculum commonly in use comprises a pair of broaddilator blades which are pivoted together and movable apart wheninserted into the vaginal cavity to cause the vagina to dilate.

While such a vaginal speculum performs satisfactorily in manysituations, it does have some disadvantages. One disadvantage is thateach of the dilator blades presents a peripheral edge which can causediscomfort during insertion. A further disadvantage is that because oftheir broad nature the blades can obscure a significant part of thevaginal walls thereby obscuring matters of concern such as vaginalwarts. A still further disadvantage is that the vaginal walls can urgethe dilator blades together which can cause the blades to grip thecervix and thereby cause pain on removal of the speculum. A stillfurther disadvantage is that the blades can pinch the vaginal wall whenpivoted together prior to withdrawal of the speculum.

The present invention seeks to provide an apparatus for dilating a bodycavity and in particular to provide a vaginal speculum which overcomesat least some of the disadvantages of the conventional speculum referredto above, or at least provides a useful alternative to such a speculum.

SUMMARY OF THE INVENTION

The invention provides an apparatus for dilating a body cavitycomprising at least two elongate elements positioned in generallyside-by-side relationship and movable laterally with respect to eachother between a contracted condition wherein first end sections of theelongate elements are closely adjacent one another for insertion intothe body cavity and an expanded condition wherein the first end sectionsof the elongate elements are circumferentially spaced apart for dilatingthe body cavity.

While there may be two or more of the elongate elements, it isparticularly convenient that there be four such elements.

The elongate elements are each preferably firm yet resiliently flexiblealong the length thereof.

The elongate elements are preferably thin in profile and of circular orother rounded cross-section.

In the contracted position, the first end sections of the elongateelements are closely adjacent to present a compact shape for insertioninto the body cavity.

In the expanded condition, the elongate elements define therebetween acentral region of open-ended elongate shape through which gynaecologicaloperations and procedures may be performed.

The elongate elements may be arranged to normally occupy one of thecontracted or expanded conditions, a control means being provided forselectively moving the elongate elements from that one condition to theother condition. Conveniently, the elongate elements normally occupy thecontracted condition and operation of the control means causes movementof the elongate elements from the contracted condition to the expandedcondition.

The control means may comprise a control ring encircling the elongateelements and adjustment means extending between each elongate elementand the control ring, the adjustment means being operable to move atleast two of the elongate elements with respect to the control ringthereby moving the elongate elements from said one condition to theother condition. Preferably the adjustment means is operable to move allof the elongate elements with respect to the control ring.

The adjustment means may comprise a funicular element such as a cablelaced between the control ring and the elongate elements wherebytensioning of the cable draws the elongate elements outwardly towardsthe ring.

The funicular element may be tensioned by any suitable means such as atensioning device around which the funicular element can be wound fortensioning thereof. The tensioning device may have a locking means forselectively locking the tensioning device against rotation in thereverse direction to prevent unwinding of the funicular element.

The control means is preferably so positioned in relation to theelongate element that it is disposed exteriorly of the body cavity whenthe elongate elements are inserted therein.

The elongate elements may be retained in said side-by-side relationshipby a retaining means. The retaining means may be disposed on a secondend section of the elongate elements opposite to said first end sectionthereof.

The retaining means may comprise a closed loop. The closed loop may beof flexible construction. In particular, the closed loop may beresiliently flexible.

BRIEF DESCRIPTION OF THE DRAWINGS

The invention will be better understood by reference to the followingdescription of several specific embodiments thereof as shown in theaccompanying drawings in which:

FIG. 1 is a perspective view of a vaginal speculum according to a firstembodiment shown in a contracted condition;

FIG. 2 is a perspective view similar to FIG. 1 with the exception thatthat the vaginal speculum is shown moving from the contracted conditionto an expanded condition;

FIG. 3 is also a view similar to FIG. 1 with the exception that thevaginal speculum is shown in the expanded condition;

FIG. 4 is a view similar to FIG. 3 with the exception that the vaginalspeculum is shown in a further expanded condition;

FIG. 5 is a schematic view showing the vaginal speculum prior toinsertion into a vagina;

FIG. 6 is a schematic view showing the vaginal speculum in position inthe vagina prior to expansion thereof into the expanded condition;

FIG. 7 is a schematic view showing the vaginal speculum in an expandedcondition in the vagina to cause dilation thereof;

FIG. 8 is a side view of the arrangement shown in FIG. 7; and

FIG. 9 is a perspective view of a vaginal speculum according to a secondembodiment.

DESCRIPTION OF PREFERRED EMBODIMENTS

The first embodiment, which is shown in FIGS. 1 to 8 of the accompanyingdrawings, is directed to a vaginal speculum 10 comprising four elongateelements 11 of firm yet resiliently flexible construction.

The elongate elements 11 each have a first end section 12 and a secondend section 14. Each elongate element 11 is thin in profile and ofcircular cross-section. The elongate elements 11 are positioned inside-by-side relationship and are linked one to another at the secondend section 14 thereof by a retaining means 13. The retaining means 13comprises a resiliently flexible band 15 having four integral sleeveportions 17 each for receiving and retaining the adjacent end section 14of one of the elongate elements 11. The end section of each elongateelement 11 extends beyond its respective sleeve portion 17, the purposeof which will be explained later.

The retaining means 13 supports the elongate elements 11 in side-by-siderelationship and allows them to move between a contracted condition inwhich the first end sections 12 of the elongate elements 11 are closelyadjacent each other (as best seen in FIG. 1 of the drawings) to presenta narrow shape for insertion into a vagina, and an expanded condition inwhich the elongate elements are circumferentially spaced apart (as bestseen in FIG. 3 of the drawings) to define therebetween a central regionof an open-ended elongate shape.

While in the side-by-side relationship the elongate elements 11 are alsodisposed angularly with respect to each other in the contractedcondition to taper inwardly from the retaining means 13 to touch oneanother at the first end sections 12. Further, while in the side-by-siderelationship the elongate elements 11 are also disposed angularly in theexpanded condition to taper in the outward direction. The flexiblenature of the retaining means 13 allows the elongate elements 11 to moveangularly between the contracted and expanded conditions.

A control means 30 is provided for selectively moving the elongateelements from the contracted condition to the expanded condition. Thecontrol means is provided intermediate the ends of the elongate elements11 at a location away from that first end sections 12 of the elongateelements 11 which are receivable in the vagina.

The control means 30 comprises a control ring 31 which encircles theelongate elements 11 and an adjustment means 33 operable between thecontrol ring and the elongate elements for moving the elongate elementsfrom the contracted condition to the expanded condition. The adjustmentmeans 33 comprises a funicular element 35 in the form of a cable whichis laced between a plurality of circumferentially spaced holes 37provided in the control ring 31 and a hole 39 provided in a lug 41 oneach elongate element 11. With this arrangement, the cable 35 isprovided with a plurality of loops 43 each of which extends between thecontrol ring 31 and a respective one of the elongate elements 11. Upontensioning of the cable 35, the loops are caused to contract therebypulling the elongate elements radially outwardly with respect to thecontrol ring from the contracted condition as shown in FIG. 1, throughthe intermediate position shown in FIG. 2, and into the expandedcondition shown in FIG. 3.

A tensioning device 50 is provided for tensioning the cable 35. Thetensioning device 50 comprises a shaft 51 having a barrel portion 52about which the cable 35 can be wound and a handle portion 53 forrotating the shaft to cause winding of the cable about the barrelportion 52. The handle 53 incorporates two diametrally opposed hooks 55,either one of which can be engaged with one of the elongate elements 11in the manner shown in FIG. 3 to prevent rotation of the shaft 51 whenthe cable is wound around the barrel and thereby prevent unintentionalunwinding of the cable to release the elongate elements from theexpanded condition.

A supplementary control means 60 is provided for selectively contractingthe second end sections 14 of the elongate elements 11 and therebyfurther expanding the first end sections 12 thereof, as shown in FIG. 4of the drawings. The supplementary control means 60 comprises a cable 61threaded through apertures 63 in lugs 65 provided on the ends of theelongate elements 11 which extend beyond the sleeve portions 17 in theretaining means 13. Tensioning of the cable 61 draws the second endsections 14 of the elongate elements 11 inwardly. The cable 61 istensioned by a supplementary tensioning device 63 comprising a shaft 66having a barrel portion 67 and a handle 69. The cable 61 is tensioned byrotating the shaft 65 to cause the cable 61 to wind around the barrelportion 67.

The supplementary control means 60 may well not be used in normalcircumstances but rather only in circumstances where additional dilationof a vagina is necessary.

Operation of the vaginal speculum 10 will now be described withreference to FIGS. 5 to 8 of the drawings. The relevant anatomicalarrangement of a patient 70 on whom the vaginal speculum is used is alsoshown. The anatomical arrangement of the patient 70 comprises a vagina71 having a vaginal wall 72 extending between an outer end 73 and aninner end 75 into which a cervix 77 projects.

With the vaginal speculum 10 in the contracted condition, the first endsections 12 of the elongate elements 11 are presented to the vagina 71,as shown in FIG. 5. The elongate elements 11 are inserted into thevagina 71 and typically locate in a region at the inner end thereof 75adjacent the cervix 77, as shown in FIG. 6 of the drawings.

The control device 30 is then operated to move the elongate elements 11from the contracted condition towards the expanded condition. As theelongate elements 11 move towards the expanded condition, they assume acircumferentially spaced apart arrangement and bear against the vaginalwalls 72 at circumferentially spaced locations, as best illustrated inFIG. 7 of the drawings. Continued outward movement of the elongateelements 11 causes dilation of the vagina 71 and thereby provides aclear view of the cervical region. In the expanded condition, the fourelongate elements 11 define therebetween a central region of anopen-ended elongate shape through which the vaginal walls and cervicalregion can be inspected. This also provides good access for aninstrument such as a swab. Further, access is available through thespaces between adjacent elongate elements, thereby allowing an angularapproach to the dilated vagina. The speculum 10 ensures that the vagina71 is maintained in the dilated condition throughout the procedure.

The resiliently flexible nature of the elongate elements 11 allows themto deflect slightly to provide somewhat uniform pressure on the vaginalwalls 72 along the length thereof.

At the completion of the gynaecological procedure, the elongate elements11 can be returned to the contracted condition by unwinding the cablefrom the tensioning device 50. The pressure applied to the elongateelements 11 causes them to move towards the contracted condition as thecable is unwound. The speculum can be withdrawn once it has contractedsufficiently.

Referring now to FIG. 9 of the drawings, the speculum 10 according tothe second embodiment is somewhat similar to that of the firstembodiment with the exception of the retaining means 13. In thisembodiment, the retaining means 13 comprises a band 81 of elasticmaterial which is secured to each elongate element 11 between twolongitudinally space retaining lugs 83 mounted thereon. The band 81 hasa slit 85 which accommodates each retaining lug 83 to thereby preventsliding movement of the elongate element around the band. Operation ofthe vaginal speculum according to the second embodiment is substantiallythe same as that according to the first embodiment.

From the foregoing, it is evident that the two embodiments provide asimple yet highly effective vaginal speculum. The vaginal speculum isconvenient to install in that it is merely positioned in the contractedcondition and then inserted into the vagina. When in the expandedcondition, the vaginal speculum allows good vision and convenient accessalong the central region thereof defined between the circumferentiallyspaced elongate elements. The curved contact walls of the elongateelements minimise discomfort and the thin profile of the elongateelements minimises the extent to which the vaginal walls are obstructedfrom vision.

It should be appreciated that the scope of the invention is not limitedto the scope of the two embodiments described.

I claim:
 1. Apparatus for dilating body cavity comprising:at least twoelongate elements positioned in generally side-by-side relationship andmovable laterally with respect to each other between a contractedcondition wherein first end sections of the elongate elements areclosely adjacent one another for insertion into the body cavity and anexpanded condition wherein the first end sections of the elongateelements are circumferentially spaced apart for dilating the bodycavity; and a control means for selectively moving the elongate elementsfrom one of said contracted and expanded conditions to the other of saidcontracted and expanded conditions, said control means including: acontrol ring encircling the elongate elements, and adjustment meansextending between adjacent elongate elements and the control ring, theadjustment means being operable to move said elongate elements withrespect to the control ring and thereby moving said elongate elementsfrom said one condition to said other condition, the adjustment meansincluding a funicular element laced between the control ring and saidelongate elements whereby tensioning of the funicular element draws saidelongate elements outwardly towards the ring.
 2. Apparatus according toclaim 1 wherein there are four elongate elements.
 3. Apparatus accordingto claim 1 wherein the elongate elements are thin in profile. 4.Apparatus according to claim 1 wherein the elongate elements are each ofrounded cross-section.
 5. Apparatus according to claim 1 wherein theelongate elements are firm yet resiliently flexible along the lengththereof.
 6. Apparatus according to claim 1 wherein the elongate elementsnormally occupy the contracted condition and operation of the controlmeans causes movement of the elongate elements from the contractedcondition to the expanded condition.
 7. Apparatus according to claim 1wherein there is provided a tensioning device around which the funicularelement can be wound for tensioning thereof.
 8. Apparatus according toclaim 7 wherein said tensioning device further includes a locking meansfor selectively locking the tensioning device against rotation in thereverse direction to prevent unwinding the funicular element. 9.Apparatus according to claim 1 wherein a retaining means is provided forretaining the elongate elements in said side-by-side relationship. 10.Apparatus according to claim 9 wherein the retaining means is disposedon a second end section of the elongate elements opposite to said firstend section thereof.
 11. Apparatus according to claim 10 wherein saidretaining means comprises a closed loop.
 12. Apparatus according toclaim 9 wherein said retaining means comprises a closed loop. 13.Apparatus according to claim 12 wherein the closed loop is flexible. 14.Apparatus according to claim 13 wherein the closed loop is resilientlyflexible.